Fewer Doctors Treating For Free

The percentage of physicians who provide free care to the poor has dropped over the past decade, and this is fast becoming huge problem for America's quickly growing number of uninsured people.

According to a study conducted by the Center for Studying Health System Change, released on Thursday, About three-quarters of physicians provided charity care in the mid-1990s, compared with about two-thirds now. This is due to financial and time constraints. Though the percentage reduction is from all fields the highest percentage of free care comes from Surgeons about 78%. That is probably because many of these doctors have to treat uninsured patients in the ER. Over 60% of the pediatricians provided free care.

Dr. Peter Cunningham, senior researcher for the center, said he believes the drop in charity care is mainly due to two trends, No changes in the reimbursement rates from the government and lower fees that insurers are negotiating on behalf of their customers. Previously the doctors could charge the patients who pay much higher. Many doctors are also leaving private practices to join larger groups and companies.

The president of the American Medical Association Dr. J. Edward Hill, a family physician from Mississippi said that it was not surprising as the doctors are committed to providing charity care, but many are constrained by time and finances. Busy schedules, reduced reimbursement rates and high medical-school debt appear to be contributing to the problem. Fewer medical students are going into primary care because they can make more money in specialties, Insurance companies pay specialists a higher rate because they provide critical care such as kidney transplants and heart bypass surgery.

An increase in demand for physician services has meant that doctors are increasingly squeezed for time, reducing their availability to volunteer and provide free services, he said. The study reveled that about 80 percent of physicians in solo practice or small groups -- employing 10 physicians or fewer -- provided charity care in 2004 to 2005, and this has not changed significantly since 1996-1997. By comparison, physicians in larger groups and institutional-based practices, like medical schools or hospitals, are much less likely to provide charity care, and charity care among these physicians declined sharply.

Dr.Hill says that charity is not the answer to the solution, and feels that a, more important solution should be developed. He says that the AMA supports the use of tax credits to make health insurance more affordable and changes in insurance regulation that would reduce costs. Dr. Peter Cunningham, senior researcher for the center, feels with fewer physicians providing charity care, the uninsured people are going to seek care in hospitals emergency rooms. And care in emergency rooms is more costly and less efficient.

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